title: Cost-effectiveness of drug-eluting stents in patients with stable coronary artery disease.
abstract: OBJECTIVE
  Drug-eluting stents (DESs) have been shown to reduce in-stent restenosis and target vessel revascularization (TVR) in large clinical trials. We conducted this study to elucidate the differences in the cost and clinical outcome of DESs and bare metal stents (BMSs).
  
  
  METHODS
  We retrospectively analyzed the clinical data and costs of patients with stable angina treated with coronary stents from September 2003 to January 2005 at the National Taiwan University Hospital, Taipei, Taiwan.
  
  
  RESULTS
  We enrolled 186 patients treated with DESs and 194 patients treated with BMSs. The use of DESs is associated with a lower rate of TVR compared with that with BMSs (12%vs. 22%, p = 0.011). Compared with the BMS group, the overall costs were significantly higher in the DES group (NT$352,495 ± 140,408 vs. NT$298,947 ± 131,289, p<0.001). The incremental cost to avoid one TVR at 2 years was NT$546,444 (95% confidence interval: NT$151,071-2,565,793).
  
  
  CONCLUSIONS
  The use of DESs reduces the rate of TVR at 2 years after intervention, but is probably not cost-effective compared with BMSs in patients with stable coronary artery disease.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
authors.forename: Chi-Sheng
authors.initials: CS
authors.lastname: Hung
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Cheng
authors.forename: Chia-Lun
authors.initials: CL
authors.lastname: Chao
authors.forename: Hsien-Li
authors.initials: HL
authors.lastname: Kao
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.forename: Neng-Pai
authors.initials: NP
authors.lastname: Lin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D003324:Coronary Artery Disease / Q000191:economics / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000191:economics; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents